Friday, October 02, 2009

Computer glitches in NHS IT system force patients to wait six months

The Brits have spent £12.7 BILLION and many years on a new computer system for their hospitals but it is still not working properly. What does it take to convince them that they will never get it right? They have changed contractors etc. but nothing seems to help. But that old Leftist catnip of centralized control is just too strong for Britain's Leftist government to resist. They will keep wasting taxpayers' money on the garbage until they get kicked out of office

Thousands of people are being forced to wait six months or more for hospital treatment or tests because of problems with the £12.7 billion project to upgrade NHS computer systems, The Times has learnt. More than 14,000 patients at a major London trust have already had to endure waiting times that exceed government guidelines. The trust was one of the first to install electronic patient records. Similar systems are being rolled out across England.

The Department of Health says that nobody should wait more than 18 weeks to receive hospital treatment from the time they are referred by a GP, unless they choose to wait longer. But Barts and the London NHS Trust, which introduced the system in April last year, has a backlog of 22,000 electronic patient records on its 18-week waiting list. Many of these are thought to be duplicates but at least 14,000 are considered by trust staff to be the records of individual patients who may have been waiting longer than 18 weeks.

The figures, seen by The Times and Computer Weekly magazine, were reported to the trust’s board last month as part of a continuing investigation. Staff and doctors at the trust lost track of thousands of patients when the computerised records were introduced. The backlog means that many patients could end up waiting more than 26 weeks or even a year.

Barts and the London, which serves two million people in East London, the City and Canary Wharf, was one of the first health authorities in the country to upgrade to a new care records system as part of the National Programme for IT. Doctors at the trust’s three hospitals — Barts in the City, the Royal London in Whitechapel and the London Chest Hospital in Bethnal Green — have complained about inaccuracies in data and say that staff do not always understand the way the system works in combination with the trust’s practices.

Health officials said that they had no evidence that any patients had come to harm because of the delays, but the trust was rated as “under-performing” by the Department of Health last month and could be fined for failing to meet the performance targets.

Ross Anderson, a professor of computing at the University of Cambridge, warned that other hospitals had also suffered penalties because of disruption to their waiting lists caused by the new systems. “Hospital managers have good reason to ask why they are ordered to put in systems that are not fit for purpose and then punished for not meeting targets when there has been a balls-up,” he said. A spokeswoman for the trust said: “It has been a frustration for everyone that our desire to meet the 18-week national target has been compromised by previous weaknesses in our information management and administration systems.”


You mislead!

Fact-checking Obama

It is a good thing that other congressmen did not follow Rep. Joe Wilson’s lead. If they yelled out every time President Obama said something untrue about health care, they would quickly find themselves growing hoarse.

By our count, the president made more than 20 inaccurate claims in his speech to Congress. We have excluded several comments that are deeply misleading but not outright false. (For example: Obama pledged not to tap the Medicare trust fund to pay for reform. But there is no money in that “trust fund,” anyway, so the pledge is meaningless.) Even so, we may have missed one or more false statements by the president. Our failure to include one of his comments in the following list should not be taken to constitute an endorsement of its accuracy, let alone wisdom.

1. “Buying insurance on your own costs you three times as much as the coverage you get from your employer.” The Congressional Budget Office writes, “Premiums for policies purchased in the individual insurance market are, on average, much lower — about one-third lower for single coverage and one-half lower for family policies.” It is true that individual insurance policies are generally 30 percent less comprehensive than employer-provided insurance, and comparable individual policies are about twice as expensive. But much of the extra cost is a function of the tax penalty on purchasing such insurance and the stunted market that penalty has yielded.

2. “There are now more than 30 million American citizens who cannot get coverage.”An outright falsehood, whether you use the president’s noncitizen-free estimate or the standard, questionable estimate of 46 million uninsured residents.

A study prepared for the federal government estimates that 9 million people counted as “uninsured” in the standard estimate are in fact enrolled in Medicaid. The left-leaning Urban Institute estimates that 12 million are eligible but not enrolled, meaning they could get coverage at any time. Health economists Mark Pauly of the University of Pennsylvania and Kate Bundorf of Stanford estimate that one quarter to three quarters of the uninsured can afford to purchase coverage, but choose not to do so.

3.“And every day, 14,000 Americans lose their coverage.” The paper that generated this estimate assumed that two months of severe job losses would continue forever. Applying that paper’s methodology to a broader period of rising unemployment (January 2008 through August 2009) produces a figure below 9,000.

It also assumes those coverage losses are permanent. Like many of the 46 million Americans we label “uninsured,” many of those 9,000 will regain coverage after a number of months. (David Freddoso illustrates the absurdity of assuming that all coverage losses are permanent.)

4. “One man from Illinois lost his coverage in the middle of chemotherapy. . . . They delayed his treatment, and he died because of it.” He didn’t die because of it. The originator of this false claim, a writer for Slate named Timothy Noah, has admitted he got it wrong.

5. “Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.” Scott Harrington supplied more facts in the Wall Street Journal: “The woman’s testimony at the June 16 hearing confirms that her surgery was delayed several months. It also suggests that the dermatologist’s chart may have described her skin condition as precancerous, that the insurer also took issue with an apparent failure to disclose an earlier problem with an irregular heartbeat, and that she knowingly underreported her weight on the application.” The woman deserves sympathy, but Obama has stretched the truth here.

6. Rising costs are “why so many employers . . . are forcing their employees to pay more for insurance.” Perhaps no other issue generates as much of a consensus among health-care economists as this one: The “employer’s share” of employees’ health-care costs comes out of those employees’ wages, not out of profits. In this comment and in five others in his speech, Obama contradicts that basic truth. Employers aren’t forcing their employees to pick up a larger share of the bill because they can’t. Workers are already paying the entire bill.

More here

More liberal lies about national health care

Note: This is the latest in Coulter's multi-part series debunking "liberal lies" about health care

17) America's low ranking on international comparisons of infant mortality proves other countries' socialist health-care systems are better than ours.

America has had a comparatively high infant mortality rate since we've been measuring these things, going back to at least the '20s. This was the case long before European countries adopted their cradle-to-grave welfare schemes and all while the U.S. was the wealthiest country on Earth.

One factor contributing to the U.S.'s infant mortality rate is that blacks have intractably high infant mortality rates – irrespective of age, education, socioeconomic status and so on. No one knows why. Neither medical care nor discrimination can explain it: Hispanics in the U.S. have lower infant mortality rates than either blacks or whites. Give Switzerland or Japan our ethnically diverse population and see how they stack up on infant mortality rates.

Even with a higher-risk population, the alleged differences in infant mortality are negligible. We're talking about 7 infant deaths per 1,000 live births in the U.S. compared to 5 deaths per 1,000 for Britain and Canada. This is a rounding error – perhaps literally when you consider that the U.S. tabulates every birth, even in poor, small and remote areas, while other countries are not always so meticulous.

But the international comparisons in "infant mortality" rates aren't comparing the same thing, anyway. We also count every baby who shows any sign of life, irrespective of size or weight at birth. By contrast, in much of Europe, babies born before 26 weeks' gestation are not considered "live births." Switzerland only counts babies who are at least 30 centimeters long (11.8 inches) as being born alive. In Canada, Austria and Germany, only babies weighing at least a pound are considered live births.

And of course, in Milan it's not considered living if the baby isn't born within driving distance of the Côte d'Azur. By excluding the little guys, these countries have simply redefined about one-third of what we call "infant deaths" in America as "miscarriages."

Moreover, many industrialized nations, such as France, Hong Kong and Japan – the infant mortality champion – don't count infant deaths that occur in the 24 hours after birth. Almost half of infant deaths in the U.S. occur in the first day. Also contributing to the higher mortality rate of U.S. newborns: Peter Singer lives here.

But members of Congress, such as Reps. Dennis Kucinich, Jim Moran and John Olver, have all cited the U.S.'s relatively poor ranking in infant mortality among developed nations as proof that our medical care sucks. This is despite the fact that in many countries a baby born the size of Dennis Kucinich would not be considered a live birth.

Apart from the fact that we count – and try to save – all our babies, infant mortality is among the worst measures of a nation's medical care because so much of it is tied to lifestyle choices, such as the choice to have children out of wedlock, as teenagers or while addicted to crack. The main causes of infant mortality – aside from major birth defects – are prematurity and low birth-weight. And the main causes of low birth-weight are: smoking, illegitimacy and teenage births. Americans lead most of the developed world in all three categories. Oh, and thank you for that, Britney Spears.

Although we have a lot more low birth-weight and premature babies for both demographic and lifestyle reasons, at-risk newborns are more likely to survive in America than anywhere else in the world. Japan, Norway and the other countries with better infant mortality rates would see them go through the roof if they had to deal with the same pregnancies that American doctors do. As Nicholas Eberstadt demonstrates in his book "The Tyranny of Numbers: Mismeasurement and Misrule," American hospitals do so well with low birth-weight babies that if Japan had our medical care with their low birth-weight babies, another third of their babies would survive, making it even harder for an American kid to get into MIT.

But I think it's terrific that liberals are finally willing to start looking at outcomes to judge a system. I say we start right away with the public schools! In international comparisons, American 12th-graders rank in the 14th percentile in math and the 29th percentile in science. The U.S. outperformed only Cyprus and South Africa in general math and science knowledge. Worse, Asian countries didn't participate in the last 12th-grade assessment tests. Imagine how much worse our public schools would look – assuming that were possible – if we allowed other countries to exclude one-half of their worst performers!

That's exactly what liberals are doing when they tout America's rotten infant mortality rate compared to other countries. They look for any category that makes our medical care look worse than the rest of the world – and then neglect to tell us that the rest of the world counts our premature and low birth-weight babies as "miscarriages."

As long as American liberals are going to keep announcing that they're embarrassed for their country, how about being embarrassed by our public schools or by our ridiculous trial lawyer culture that other countries find laughable?

Don't be discouraged, liberals – when it comes to utterly frivolous lawsuits against obstetricians presented to illiterate jurors so that John and Elizabeth Edwards can live in an 80-room house, we're still No. 1!


Top Liberal Agrees: Cost of Health Reform Could Wreck Economy

Startling revelations sometimes turn up in unexpected places. For instance, one of the nation's most thoughtful, influential liberals recently conceded in a New York Times book review that Democratic plans for health care reform could well wreck the U.S. economy but he insisted that the achievement would be worth the cost.

Robert Reich, who served as Bill Clinton's Labor Secretary and now teaches public policy at Berkeley, praised the new book The Heart of Power: Health and Politics in the Oval Office which described 60 years of efforts to expand the government role in medical care. Concerning authors David Blumental and James A. Morone, Reich baldly declared that their most provocative finding is that presidents who have been most successful in moving the country toward universal health coverage have disregarded or overruled their economic advisers. Plans to expand coverage have consistently drawn cautions or condemnations from economic teams in every administration, from Harry Truman's down to George W. Bush's.

Neither Reich, nor the authors he cites, chose to challenge this bipartisan consensus from both Democratic and Republican economists over some six decades. Instead, The Heart of Power highlights the shameless effort by Lyndon Johnson to conceal the true costs of Medicare in order to secure its passage in 1965. In a taped conversation with Senator Ted Kennedy, the president attacked his own economic advisors because the fools had to go to projecting those costs down the road five or six years. LBJ deliberately misled the public by lowballing the amount of money that taxpayers would need to spend to secure health coverage for senior citizens, contradicting the official economic estimates and intentionally distorting the truth. Ill spend the goddamned money, he indignantly (though privately) declared. As Secretary Reich admiringly insisted: An honest economic forecast would most likely have sunk Medicare.

He continued with the hugely damning admission that economists have always had a point when they cautioned against expansion of government spending for health care. Its not so much that presidential economic advisers have been wrong in fact, Medicare is well on its way to bankrupting the nation but that they are typically in the business of thinking small and trying to minimize risk, while the herculean task of expanding health coverage entails great vision and large risk. Economic advice is important, but its only one source of wisdom.

How many Americans would agree with the proposition that worrying about bankrupting the nation amounts to thinking small--- or that spending the Republic into crippling debt with no strategy for repayment amounts to great vision?

If President Obama and other advocates for sweeping health care reform are as candid as Robert Reich, the public will emphatically reject their misguided efforts to restructure one-sixth of the American economy. As history shows, deliberate distortion and understatement of costs have played an essential role in all expansions of governmental medical system entitlements. If politicians and media report honestly on the true price tag of current proposals, the people will recognize the devastating impact of such expenditures on the fragile, tentative beginnings of economic recovery. Robert Reich, Lyndon Johnson, Ted Kennedy, and Barack Obama may think its worth brutal damage to the economy to expand governmental health care but most Americans will emphatically disagree.


The Economics of Mandated Health Insurance

The status of health care reform, since Congress went on recess, has captured every columnists, pundits, and even economist’s rants and raves. Now that Congress has reconvened, the speculation of what will and will not be in the bill is coming to a close. But one thing is for sure: Congress does not want to leave without some type of government growth.

The public option quickly became unpopular due to the massive amounts of debt and government intrusion that many were proposing. Senator Max Baucus (D-MT) thought that he could garner bi-partisan support with his mandated insurance plan, but right now it has been lost in a fight over the details.

Whether or not the plan “cuts too much out of Medicare benefits,” as Senator John Coryn (R-TX) stated to reporters, is salient. But, it’s really the core principle of the effects of a mandated insurance plan will have on the American people is what needs to be in front of the debate.

Mandates for certain types of coverage are not new, but mandates requiring citizens to buy health care insurance are. Many states have already passed plans, containing some sort of mandates, including Massachusetts under former Republican Presidential Candidate and Governor Mitt Romney.

So it is no surprise why the Democrats have taken the mandated health insurance route over the public option route, as of late. Mandated health insurance is an escape route that government takes for an indirect tax on people’s income. Without raising the income tax, the government mandate will reduce the employee’s wages by the amount it costs for the employer to offer it.

Lawrence Summers, economist and current Director of Obama’s National Economic Council, wrote in 1989 that after a mandate was put in “A new equilibrium level of employment and wages is reached, with lower wages and employment…” because (unlike government) business cannot just print new money to make up for new costs.

And that’s not all. Paul Hsieh, MD, and founding member of Freedom and Individual Rights in Medicine (FIRM), found in Massachusetts that once mandates were in place the cost to get an insurance plan rose rapidly. This is because the government decides what must be covered in an insurance plan and special interest groups make sure the politicians include everything under the sun. Hsieh states: “For example, Massachusetts currently requires insurance plans to include forty-three mandatory benefits, including in vitro fertilization, blood lead poisoning treatment, and chiropractor services – whether or not customers want them. Residents must purchase alcoholism therapy benefits, even if they are teetotalers. These mandated benefits have raised the costs of health insurance in Massachusetts by 23 to 56 percent.”

Economically, mandated coverage lowers “wages and employment,” while not even controlling cost. It puts more red tape and burden on the small business with penalties possibly including jail time.

And with Barack Obama’s commitment to eventually getting the United States on a single-payer plan, this individual mandate “compromise” will be nothing but a facilitator of that very plan.


The health insurance market is not free

With the government's healthcare plan looming above us, there has perhaps never been a better time for Americans to understand the excessive costs of health care, and the origins of these vast increases.

While many commentators have been quick to blame the free market for these costs, health insurance in America is not completely "free." For instance, in Idaho, Maine, Massachusetts, New York, New Jersey, Ohio, Rhode Island, and Vermont, there are regulations called "guaranteed issues." These force insurance companies to accept all comers, regardless of preexisting conditions.

Likewise, more than 30 other states have lesser (but very similar) regulations forcing companies to accept all comers. Such regulations allow individuals to buy insurance as soon as they need a given type of high-cost care. This is like letting a driver who causes a major accident purchase the insurance after the accident and expect all his car repair bills to be paid.

In an effort to protect themselves, insurance companies would prefer to then charge more to the person who waited until he became sick to buy insurance. However, some people cannot afford these higher payments, so the government has imposed price controls.

There are also "community ratings," which require insurance companies to charge the same amount to all members of a pool. Maine, Massachusetts, New York, New Jersey, North Dakota, Oregon, Vermont, and Washington are the most severe. These "community rating" laws effectively force insurance companies to finance people with preexisting conditions, and as a result they vastly increase the premiums for healthy people.

With community ratings in effect, an 18-year-old's premium is the same as 60-year-old's. Often, when a young and healthy person sees their premiums rise, he or she drops out of the insurance pool, which then leaves it more full of sick people, again increasing premiums for the remaining members. These community ratings contribute a great deal to the large number of uninsured, and are among the reasons why healthcare in New York and New Jersey is the most expensive in the country.

Another aspect that keeps insurance prices high is government-mandated coverage. The policies vary, but in some states, people who don't drink alcohol must purchase coverage for alcoholism, nonsmokers must purchase coverage for antismoking programs, non–drug users must purchase coverage for drug-abuse treatment, etc. Some states require consumers to purchase 50 or more types of mandated coverage. Special-interest groups are mainly behind these acts of legislation, which come from people in certain fields who want to expand the market for their services.

Government regulations also prohibit people from buying insurance from companies that are headquartered out of states that have a different set of regulations. This is an obvious barrier to entry, which decreases the supply of competing insurance companies and thus raises the price. As I noted before, each state determines the provisions that insurance companies must abide by. This means that the regulators essentially grant monopolies in each state, since insurance licenses must go through them. The barriers to entry in the health-insurance market are thus appalling.

So long as a market is highly competitive and has little or no barriers to entry, a particular firm acquiring significant market share will not always translate into greater market power. Were it easy for new health-insurance companies to enter into the market, surely we would be seeing a vast increase in them as a response to the record profits of the past few years. On the contrary, the number of health insurance companies has been on a consistent decline because of regulations and barriers to entry.

The current system of employer-provided health insurance traces back to domestic policy during the World War II era. Due to government policy, inflation grew both before and during WWII. As a "remedy," caps on wage increases were imposed by the government. In response, employers began to offer their employees health insurance to soften the blow and attract quality workers.

The federal government did not consider an increase in health benefits a violation of these wage controls, and in 1943 the IRS ruled that health benefits were tax exempt for workers. After the wage caps were abolished, health insurance benefits became seen as the norm and were not eliminated. For instance, by the early 1960s, General Motors was paying 100% of the healthcare bills for their employees (retirees included). So, anyone who claims that the high costs of health insurance originated in the "free market" is either severely mistaken or lying.

There are certain groups that profit from these governmental policies: lobbyists, who obviously carry a significant amount of political clout, and the bureaucrats themselves. However, there are many more losers than winners under the current state of affairs; and adding more government provisions would only increase the costs for taxpayers and insurance consumers.


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